Asano Toko, Kobayashi Shuichiro, Yano Masataka, Otsuka Yukihiro, Kitahara Satoshi
Service of Urology, Omori Red Cross Hospital, Tokyo, Japan.
Service of Urology, Tama-Nambu Chiiki Hospital, Tokyo, Japan.
Int Braz J Urol. 2015 Jan-Feb;41(1):116-23. doi: 10.1590/S1677-5538.IBJU.2015.01.16.
To determine the safety of continued administration of antithrombotic agents during transperineal (TP) prostate biopsy.
A total of 811 men who underwent transrectal ultrasound (TRUS)-guided TP biopsy from January 2008 to June 2012 at our two institutions were retrospectively analyzed. Among these 811 men, 672 received no antithrombotic agents (group I), 103 received and continued administration of antithrombotic agents (group II), and 36 interrupted administration of antithrombotic agents (group III). Overall complications were graded and hemorrhagic complications were compared (group I with group II) using propensity score matching (PSM) analysis.
An overall complication rate of 4.6% was recorded. Hemorrhagic complications occurred in 1.8% and they were virtually identical in all the three groups, and no severe hemorrhagic complications occurred. One patient in group III required intensive care unit admission for cerebral infarction. PSM analysis revealed no statistical difference between groups I and II with regard to the incidence of gross hematuria, perineal hematoma, and rectal bleeding. Multiple regression analysis revealed that hemorrhagic complications were associated with lower body mass index (<21 kg/m2, P=0.0058), but not with administration of antithrombotic agents.
Continued administration of antithrombotic agents does not increase the risk of hemorrhagic complications; these agents are well tolerated during TP biopsy.
确定经会阴前列腺活检期间继续使用抗血栓药物的安全性。
回顾性分析了2008年1月至2012年6月在我们两家机构接受经直肠超声引导下经会阴活检的811名男性。在这811名男性中,672名未接受抗血栓药物(I组),103名接受并继续使用抗血栓药物(II组),36名中断抗血栓药物治疗(III组)。对总体并发症进行分级,并使用倾向评分匹配(PSM)分析比较出血性并发症(I组与II组)。
记录的总体并发症发生率为4.6%。出血性并发症发生率为1.8%,在所有三组中几乎相同,且未发生严重出血性并发症。III组中有1名患者因脑梗死需要入住重症监护病房。PSM分析显示,I组和II组在肉眼血尿、会阴血肿和直肠出血发生率方面无统计学差异。多元回归分析显示,出血性并发症与较低的体重指数(<21 kg/m2,P = 0.0058)相关,但与抗血栓药物的使用无关。
继续使用抗血栓药物不会增加出血性并发症的风险;这些药物在经会阴活检期间耐受性良好。